SMOKING may have made them ill..now cancer patients are being forced to walk a gauntlet of fumes and fag ends at hospitals and clinics.

SMOKING may have made them ill..now cancer patients are being forced to walk a gauntlet of fumes and fag ends at hospitals and clinics.

Seriously ill patients arriving for ­ chemotherapy and radiography face a fug of smoke at entrances littered with butts discarded by visitors and staff.

On a single day, we snapped scores of smokers outside the Beatson Cancer Centre in Glasgow, its equivalent in Edinburgh’s Western General and in the Princess Alexandra Cancer Centre at Ninewells Hospital in Dundee.

They ignored no smoking signs and seemed oblivious to the fact that, just a few yards away, patients were being treated for cancer.

Or that treating diseases caused by smoking costs the Scottish NHS £271million a year.

Or that smoking is the biggest single cause of lung cancer.

Every hospital in Scotland has strict no smoking policies, which also apply to the grounds.

But while it is illegal to smoke inside a hospital, the rules banning smoking outside rely on public goodwill.

On the day we checked, that goodwill was depressingly absent. At the Beatson Centre in Glasgow’s Gartnavel Hospital, staff and visitors openly smoked outside and in the car park.

One man lit up underneath a poster for the cancer charity Tak Tent. Others puffed away in front of clear signs warning them of the ban.

At the Edinburgh Cancer Centre, there are regular loudspeaker announcements repeating no smoking warnings.

Despite this, people were still smoking at the entrance, even though a smoking shelter has been provided 50 yards away.

A banner at the entrance to Ninewells declares the hospital is “smoke free inside and out”.

But we spotted several smokers puffing away outside the Princess Alexandra Centre, part of the main cancer treatment unit in Tayside.

Some sat on a bench outside the unit, others smoked in the car park.

Two female staff huddled round a bin as they took a quick cigarette break just yards from the Maggie’s Centre – a charity which provides vital support and respite for cancer sufferers. Another female staff member chain-smoked as she spoke to a colleague.

To spare the smokers’ blushes, we have obscured their faces.

But yesterday Stewart Maxwell, the MSP who suggested the nationwide smoking ban in public buildings, reacted with fury.

He said: “It is unacceptable that people should be smoking outside cancer centres. This is highly irresponsible and must stop.

“There can be nothing worse for a patient than having to walk through a fog of smoke when arriving for treatment.

“Smokers should remember that some patients at these centres have terminal cancer and show more consideration.”

Colin Graham, chief executive of Cancer Support Scotland, said: “It’s very disappointing to see people smoking within the grounds of a cancer hospital; especially given the fact that smoking is the cause of more than a quarter of all deaths from the disease in the UK.

“It is a concern if people are lighting up near our building where many cancer patients visit, and it sets the wrong example.”

Health service bosses are aware of the problem and say they are trying their best to discourage smokers. Paul Ballard, deputy ­director of public health with NHS Tayside, said: “From August, an enforcement officer will be employed to ensure that both public and staff do not smoke in our grounds.”

And Dr Alison McCallum, public health director at NHS Lothian, added: “At theEdinburgh Cancer Centre and other sites in NHS Lothian we play recorded announcements informing visitors of our no smoking policy.

“There are designated smoking shelters away from entrances, no smoking signs at all locations and all patients and relatives can access any of our cessation clinics to help them kick the habit.

“We have no means of enforcing the ban, but it is especially difficult at the Western General because of the scale of the campus and other privately owned buildings around it.”

A spokeswoman for NHS Greater Glasgow and Clyde said: “A minority of people continue to smoke on our grounds despite our strict no smoking policy.

“We have deployed a range of posters and gadgets to persuade people not to smoke in the grounds including large signs, posters, smoke detectors and automated voice warning systems.

“These measures have had some success but the problem remains and is of concern to us.”

In 2006, Scotland became the first country in the UK to ban smoking in public places, but one in five Scots still smokes.

Around 13,000 deaths every year are smoking related – 25 per cent of all fatalities in Scotland, rising to 42 per cent in some disadvantaged areas.

Smoking also contributes to around 90 per cent of the 4000 lung cancer deaths each year.

Smoking also costs Scotland’s economy nearly £1.1billion a year, with an estimated £692million lost to smoking breaks, absenteeism among smokers and the lost output due to premature deaths.

This contrasts with the £940million the Government receives from tobacco tax.

Since the smoking ban came into force there has been a 17 per cent reduction in heart attack admissions to hospital and a 39 per cent reduction in second-hand smoke exposure.

A study by Glasgow University, published last year, showed a 15 per cent reduction in the number of children with asthma being admitted to hospital.